Jump to

Abstract

Background Several previous studies and a meta-analysis failed to find an association between ischemic heart disease (IHD) and seropositivity to Helicobacter Pylori (Hp). The potential association between IHD and virulent strains of Hp expressing the cytotoxin-associated gene product A (CagA) however is still debated.

Methods We performed a meta-analysis including 13 epidemiological studies (3 prospective and 10 retrospective), involving a total of 5503 patients, on the association between seropositivity to CagA and IHD.

Results Seropositivity to CagA, Hp virulent strains, was significantly associated with the occurence of ischemic heart disease: 1.50 (1.22–1.84) [random odds ratio (OR), 95% confidence interval (CI)], p=0.0001. Heterogeneity was found, χ2 =20.2, p= 0.06. A sensitivity analysis, excluding studies that gave the individual strongest positive association and with a large CI and a small sample size, confirmed the main result. A pre-specified subgroup analysis according to the type of study: retrospective or prospective confirmed the global meta-analysis result in both subgroups.

Conclusion This meta-analysis shows a significant association between seropositivity to CagA virulent strains of Helicobacter pylori and the occurrence of ischemic heart disease.